MEDICARE: KRISTIN RAE COCHRAN MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	60882324	WA
2	106H00000X	Marriage & Family Therapist	61070816	WA

General Provider Information

NPI Number	:	1821567322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN RAE COCHRAN MA

Provider Business Mailing Address
First Line	:	1414 W GARLAND AVE STE 108
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-2615
Country	:	US
Telephone Number	:	509-903-8596
Fax Number	:

Provider Business Practice Location Address
First Line	:	1414 W GARLAND AVE STE 108
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-2615
Country	:	US
Telephone Number	:	509-903-8596
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2018
Last Update Date	:	11/21/2023

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Directions to “ KRISTIN RAE COCHRAN MA” Practice Location

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